Lee Si-Hak, Kim Ki-Hyun, Choi Cheol Woong, Kim Su Jin, Kim Dae-Hwan, Choi Chang In, Jeon Tae-Yong, Kim Dong-Heon, Hwang Sun-Hwi
Departments of Surgery.
Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Kyungsangnam-do.
Surg Laparosc Endosc Percutan Tech. 2017 Dec;27(6):485-490. doi: 10.1097/SLE.0000000000000489.
This study introduces a novel technique for liver retraction during laparoscopic gastrectomy and assesses its impact on postoperative recovery. This study included 139 patients in whom Nelaton catheters (n=57) or Nathanson retractors (n=82) were used for liver retraction. Serum liver enzyme levels were measured preoperatively and on the first, second, third, fifth, and seventh postoperative days. Clinicopathologic features and postoperative recovery variables between the 2 groups were compared. The aspartate aminotransferase, alanine aminotransferase, and C-reactive protein levels were significantly lower (P<0.001, P<0.001, and P=0.007, respectively), and the day of first flatus, the day of initiating a soft diet, and the length of hospital stay were shorter in the Nelaton catheter U-shaped retractor group than those seen in the Nathanson retractor group (P=0.035, P=0.002, and P=0.024, respectively). Atraumatic liver retraction with Nelaton catheters is recommended in laparoscopic gastrectomy.
本研究介绍了一种腹腔镜胃切除术期间肝脏牵拉的新技术,并评估其对术后恢复的影响。本研究纳入了139例使用内拉通导管(n = 57)或纳森森牵开器(n = 82)进行肝脏牵拉的患者。术前及术后第1、2、3、5和7天测量血清肝酶水平。比较两组之间的临床病理特征和术后恢复变量。内拉通导管U形牵开器组的天冬氨酸转氨酶、丙氨酸转氨酶和C反应蛋白水平显著较低(分别为P<0.001、P<0.001和P = 0.007),且首次排气日、开始进食软食日和住院时间均短于纳森森牵开器组(分别为P = 0.035、P = 0.002和P = 0.024)。建议在腹腔镜胃切除术中使用内拉通导管进行无创伤性肝脏牵拉。